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Asymptomatic bacteriuria

Nicolle, Lindsay E.

Current Opinion in Infectious Diseases:
doi: 10.1097/QCO.0000000000000019
URINARY TRACT INFECTIONS: Edited by Suzanne E. Geerlings

Purpose of review: Asymptomatic bacteriuria is a common finding. Inappropriate antimicrobial treatment of asymptomatic bacteriuria has been identified as a major issue for antimicrobial stewardship programs. This review summarizes and evaluates recent studies which extend our knowledge of the occurrence, management, and outcomes of bacteriuria.

Recent findings: The reported prevalence of bacteriuria is higher in some developing countries than generally reported for developed countries, but reasons for this remain unclear. Clinical studies of young women, renal transplant patients, and patients undergoing minor nontraumatic urologic procedures confirm that treatment of asymptomatic bacteriuria for these populations is not beneficial, and may be harmful. There is also no benefit for treatment of asymptomatic bacteriuria prior to orthopedic surgery to decrease postoperative surgical site infection. Studies continue to report substantial inappropriate antimicrobial use for treatment of asymptomatic bacteriuria.

Summary: Recent publications confirm that asymptomatic bacteriuria is benign in most patients. Management strategies for pregnant women with recurrent bacteriuria require further clarification. There is a continuing problem with inappropriate treatment of asymptomatic bacteriuria, and sustainable strategies to optimize antimicrobial use for this problem are needed.

Author Information

Departments of Internal Medicine and Medical Microbiology, University of Manitoba, Health Sciences Centre, Winnipeg, Manitoba, Canada

Correspondence to Lindsay E. Nicolle, MD, Professor, Departments of Internal Medicine and Medical Microbiology, University of Manitoba, Health Sciences Centre, Room GG443, 820 Sherbrook Street, Winnipeg, MB R3A 1R9, Canada. Tel: +1 204 787 7029; fax: +1 204 787 4826; e-mail:

© 2014 Lippincott Williams & Wilkins, Inc.